Postdonation eGFR and New-Onset Antihypertensive Medication Use After Living Kidney Donation

Area of Science:

• Nephrology
• Transplantation Medicine
• Public Health

Background:

• Limited data exists on the long-term clinical outcomes for living kidney donors.
• Understanding post-donation renal function is crucial for donor well-being.
• Associations between post-donation kidney function and medication use require investigation.

Purpose of the Study:

• To investigate the relationship between post-donation estimated glomerular filtration rate (eGFR) and antihypertensive medication (AHM) use in living kidney donors.
• To utilize a novel integrated database linking transplant registry, electronic health records, and pharmacy data.
• To identify clinical implications of reduced renal function after living kidney donation.

Main Methods:

• A cohort of 3222 living kidney donors without pre-donation hypertension was analyzed.
• Data linkage included national transplant registry, serum creatinine from electronic medical records, and pharmacy fill records (1989-2016).
• Multivariable mixed-effects modeling assessed associations between post-donation eGFR and AHM use, adjusting for donor factors.

Main Results:

• Lower post-donation eGFR showed a graded association with increased odds of AHM use.
• Independent correlates of AHM use included older donor age, Black race, higher BMI, first-degree donor-recipient relationship, and prehypertension.
• The linked database enabled tracking of post-donation serum creatinine and eGFR over time.

Conclusions:

• Reduced eGFR after living kidney donation is associated with a higher likelihood of requiring antihypertensive medication.
• This study demonstrates the utility of integrated data for assessing post-donation outcomes.
• Further research is needed to define the interplay between post-donation renal function, hypertension, and other health conditions.